ADCs are an indispensable component of medication distribution systems in pharmacies and hospitals across the country. The use of decentralized ADCs in hospitals and pharmacies has been shown to improve the reconciliation process of controlled substance inventory, first dose turnaround time, and overall staff satisfaction.
ADCs offer other advantages as well, including:
- The improved control-substance inventory reconciliation process
- Charge capture
- First-dose turnaround time, and
- Satisfaction of the staff of the pharmacy or hospital
Despite the many advantages, optimizing inventory management in ADCs can pose a significant challenge.
In most hospitals, the inventory values in ADCs are static and are calculated based on the average number of doses dispensed per day and the desired number of days of stock. The maximum (max) stock is adjusted to about six days a week in most establishments, while the periodic automatic replenishment (PAR) is set at around three days.
The restocking of the ADCs in most hospitals happens daily, avoiding any stockouts as there is usually a 3-day inventory reserve. However, variable utilization patterns of some medications in certain situations might exceed the average values resulting in stockouts.
Stockouts are a reason of concern as they directly affect patient care besides disrupting pharmacy and nursing staff workflow. Hospitals using the static inventory values to restock the ADCs face challenges such as a delay in replenishing stocked-out medications. Furthermore, as the number of ADCs increase in the hospital, the static system necessitates a concurrent rise in technical labor, which can be expensive.
To overcome the challenges mentioned above, several hospitals are switching to a dynamic inventory standard and a low inventory alert messaging system to prevent stockouts without increasing the workforce.
In contrast to the static inventory standards, which rely on the average dispensed doses every day and the desired number of days in stock, the dynamic standards consider the utilization of the medication- consistent or variable. The medicines deemed to have a constant utilization apply the average dispensed per day over 30 days, while the drugs with a variable utilization use the peak utilization within the last rolling window of 30 days.
The low inventory alert system is essentially a messaging system that informs the pharmacy staff if the inventory in an ADC falls below a predetermined percentage of the periodic automatic replenishment (par) value. Having such a system allows the pharmacist to restock the ADC before it runs out of medication
According to a study conducted in the University of Wisconsin Hospital and Clinics (UWHC), implementing dynamic inventory standards and a low inventory alert system significantly reduced the stockouts over traditional static inventory models.
When both systems were implemented concurrently, the maximum benefit was observed. However, the study also found that with a drop in the technician-to-ADC ratio, the time required to replenish the medication understandably increased.
The number of inventory runs was also not increased while these systems were implemented, suggesting the decreased stockouts are not simply the result of overstocking the cabinets.
Implementing advanced inventory management systems in ADCs can significantly reduce stockouts both in terms of number and duration. Correctly implementing such strategies ensures higher nursing, pharmacy staff, and patient satisfaction.
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